Epidermolysis bullosa (EB) refers to a group of rare, inherited dermatoses characterized by blisters and erosions at the sites of minor trauma. Gram-positive bacterial infections, primarily due to staphylococci, are a common complication in these patients. Topical antibiotics are used widely in these patients, although their efficacy and effect on development of resistance are unknown. The aims of this project are to 1) characterize the resident microbial flora of patients with epidermolysis bullosa, and alterations in this flora associated with progression of disease and both topical and parenteral antibiotic usage; 2) to elucidate the roles of colonizing and infecting flora in wound infections in patients with epidermolysis bullosa, and 3) to identify host and bacterial factors predisposing to skin colonization and infection with staphylococci.